Three Recommendations from Your OB/GYN You Should Question

It's OK to ask, "Can you tell my why you're suggesting this" when you hear these...

I may not want to admit it, but the truth is that sometimes doctors and midwives across the country practice in ways that are outdated or don’t follow current guidelines – often not intentionally, but because medicine can change rapidly and sometimes it is hard to keep up.

Or…maybe intentionally, because you may like how you’ve “always done things” and you don’t want to change. Maybe your doctor worries about medicolegal complications or patient satisfaction. I get it – and I also think we need to step back and realize that we must do more to make pregnancy and birth safer in this country. Sometimes that means changing how we practice.

The truth is that outdated recommendations can lead to unnecessary treatments, tests, procedures, costs, and even potential harm – as well as a lot of confusion for medical teams and patients alike.

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So…I want to highlight three practices or treatments that you should question if they’re recommended to you. You should be informed and feel empowered when it comes to your pregnancy and birth, and I hope this helps!

1. Scheduling an elective, non-medically indicated induction or C-sections before 39 weeks

The American College of Obstetricians and Gynecologists (ACOG) advises against scheduling elective inductions or cesarean deliveries before 39 weeks unless medically necessary. Previously, 37 weeks was considered full term, but now we understand that crucial fetal development, particularly in brain function, occurs in the final weeks. Early delivery should be reserved for medical conditions like preeclampsia. In the absence of such conditions, patience is key – even though I know it can be hard!

2. Avoiding exercise because it’s too dangerous in pregnancy

Pregnancy is a time where your body is doing a lot, but avoiding exercise out of concerns that too much strenuous activity could harm you or your baby is a very old-fashioned way of thinking – and not supported by any data. Exercising as some AMAZING benefits for you and your baby which I covered in a recent newsletter here. If your doctor or midwife tells you to cut down on exercise, ask what their reasoning is. While it’s true there are some important modifications to keep exercising safely (that I cover here) and some high-risk pregnancy scenarios where too much exercise should be avoided, for the average low-risk pregnant person exercise can often only be beneficial.

3. Bedrest as a treatment for preterm labor

Despite its common use, bed rest has shown no benefit for complications like preterm labor or high blood pressure. Instead, it poses significant risks and can lead to increased risk of developing blood clots, bone loss, muscle loss, anxiety, and depression. Research indicates that routine activity restriction is not effective, so if your provider is recommending this, it’s OK to ask why.

In summary, it’s OK to discuss these recommendations with your healthcare provider to ensure you receive the most current, evidence-based care during your pregnancy. You should feel that you can have an open dialogue with your doctor or midwife and not feel shut down or scolded for asking questions. If you do, that might be a bit of a red flag – and you can always consider finding a new provider who views your medical care as a partnership.

Until next time,

Dr. Jen